What is Infusion Therapy?Infusion therapy is when a medication or nutrient is administered through the venous blood circulation to bypass the gastrointestinal tract and prevent the breaking down of the drug by the liver, therefore ensuring the full dose is delivered. Infusion therapy may be the best option for a patient who finds oral administration ineffective, or in severe cases when it cannot be tolerated. Patients undergoing infusion therapy are comfortably seated and can receive treatment for up to 3 hours. ​What is Inflectra?Inflectra is an immunosuppressive drug and is commonly referred to as a biologic, which is chemically comparative to Remicade, with the active constituent being infliximab. This medication is a laboratory-synthesized antibody, specifically IgG1κ monoclonal antibody, which has the ability to bind strongly to a pro-inflammatory immune protein called tumour necrosis factor alpha (TNFα), and therefore functions to reduce inflammation particularly in cases of autoimmune conditions. Studies have shown that infliximab prevents the development of arthritis in mice. Even after the onset of diseases like arthritis, infliximab helps the healing process of joints.

What conditions are treated with Inflectra?Extensive clinical trials on infliximab have shown that it can be used as a primary form of treatment, especially if there are inadequate responses to other conventional therapies for people with the following autoimmune conditions:

Ulcerative colitis

Crohn disease

Rheumatoid arthritis

Psoriatic arthritis

Plaque psoriasis

Ankylosing spondylitis.

Is Inflectra safe for the at risk population?Most clinical trials have tested Inflectra on patients aged 18 to 64. The safety and efficacy of Inflectra has not yet been established in the pediatric population. For the geriatric population (≥ 65 years of age), there was a higher incidence of serious adverse effects in both infliximab and control groups, compared to younger patients. The risks and benefits of Inflectra therapy should be evaluated for geriatric patients before proceeding further.

Who should not be on Inflectra infusion therapy?The following is a list of contraindications based on a physician’s discretion:

Hypersensitivity to infliximab or any of its excipients, which include:

sucrose

polysorbate 80

monobasic sodium phosphate monohydrate

dibasic sodium phosphate dihydrate

no preservatives.

What are the adverse effects of Inflectra infusion therapy?Some of the more common adverse effects are listed below:

Since Inflectra functions by suppressing the immune system, then there is always a potential risk of infection (bacterial, fungal, or viral). If there is a serious, active infection, then therapy should be delayed or stopped.

Infusion-related reaction occurring during infusion therapy, or within an hour after infusion with typical, but rare symptoms such as fever, chills, chest pain, low or high blood pressure, headache, laboured breathing, itchiness and hives. There are very rare incidences of anaphylaxis, convulsions and rash.

Lupus-like syndrome can occur as a result of autoantibody formation to infliximab-treated patients; common symptoms of drug-induced lupus can be joint pain, muscle pain and fatigue. Monitoring specific antibodies is recommended (i.e. ANA and anti-dsDNA antibodies).

Jaundice and hepatitis can occur in rare instances, therefore continued monitoring of liver enzymes is recommended (i.e. ALT and AST).

Patients with pre-existing congestive heart failure had higher rates of cardiovascular side effects with higher doses of infliximab.

Which drugs interact with Inflectra?

Other biological therapies – concomitant administration of Inflectra with other biological therapeutics, like Abatacept or Anakinra and others, is not recommended as there is even a greater risk of infection.

Live vaccines are a potential risk for developing infection with concurrent administration.

Warfarin, cyclosporine and theophylline affect the CYP450 enzymes, which will require close monitoring.

There are no known food or herb interactions.

Is Inflectra safe in pregnancy and breastfeeding?Studies using pregnant mice did not show any evidence of drug toxicity or teratogenicity to the mouse fetus, however, it is not known whether Infectra can cause human fetal harm when administered to a pregnant woman, or how it affects the reproduction capacity. Risks and benefits need to be assessed. There is evidence that infliximab crosses the placenta and it has been detected in infants up to 6 months of age, which may increase the risk of infection.There is insufficient evidence on whether infliximab is present in human milk, however, there is a potential for adverse reactions in nursing infants. A decision should be made whether to discontinue nursing or discontinue the drug.For women of childbearing age or planning a family, adequate contraception is required for up to 6 months after the last Inflectra treatment.

Why receive Inflectra infusion therapy at Don Valley Integrative Digestive Clinic?Don Valley Integrative Digestive Clinic believes in collaboration and the integrative approach in helping patients reach their health goals. We strive to provide the highest quality of care for patients, whether it is complementary or conventional. Inflectra is administered by a highly qualified and extensively trained registered nurse and is overseen by an onsite physician. We offer a comfortable and serene atmosphere with refreshments for the duration of the infusion therapy.

To learn more about Inflectra, please see the Monograph.​For physicians who would like to enroll their patient(s), please complete our Patient Enrolment Form and fax to 647.497.6006.